Filing Details
- Accession Number:
- 0001209191-19-002922
- Form Type:
- 4
- Zero Holdings:
- No
- Publication Time:
- 2019-01-08 20:17:42
- Reporting Period:
- 2019-01-04
- Accepted Time:
- 2019-01-08 20:17:42
- SEC Url:
- Form 4 Filing
Issuer
| Cik | Name | Symbol | Sector (SIC) | IRS No |
|---|---|---|---|---|
| 1667633 | Forty Seven Inc. | FTSV | Pharmaceutical Preparations (2834) | 474065674 |
Insiders
| Cik | Name | Reported Address | Insider Title | Director | Officer | Large Shareholder | Other |
|---|---|---|---|---|---|---|---|
| 1743780 | H Chris Takimoto | C/O Forty Seven, Inc. 1490 O'Brien Drive, Suite A Menlo Park CA 94025 | Chief Medical Officer | No | Yes | No | No |
Reported Non-Derivative Transactions
| Sec. Name | Acquisiton - Disposition | Date | Amount | Price | Remaning Holdings | Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
|---|---|---|---|---|---|---|---|---|---|---|
| Common Stock | Acquisiton | 2019-01-04 | 8,000 | $2.02 | 8,000 | No | 4 | M | Direct | |
| Common Stock | Disposition | 2019-01-04 | 8,000 | $15.55 | 0 | No | 4 | S | Direct |
| Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
|---|---|---|---|---|
| No | 4 | M | Direct | |
| No | 4 | S | Direct |
Reported Derivative Transactions
| Sec. Name | Sec. Type | Acquisiton - Disposition | Date | Amount | Price | Amount - 2 | Price - 2 |
|---|---|---|---|---|---|---|---|
| Common Stock | Stock Option (right to buy) | Disposition | 2019-01-04 | 8,000 | $0.00 | 8,000 | $2.02 |
| Remaning Holdings | Exercise Date | Expiration Date | Equity Swap Involved | Transaction Form Type | Transaction Code | Nature of Ownership |
|---|---|---|---|---|---|---|
| 159,741 | 2026-02-25 | No | 4 | M | Direct |
Footnotes
- The sale reported in this Form 4 was effected pursuant to a 10b5-1 trading plan.
- The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $15.10 to $16.02, inclusive. The Reporting Person undertakes to provide the Issuer, any securityholder of the Issuer, or the Staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth this footnote.
- 1/4th of the shares subject to the option vested one year after February 8, 2016 and 1/48th of the shares subject to the option vest monthly thereafter, subject to Reporting Person's continuous service as of each such date. The shares subject to this option may be exercised prior to vesting, subject to Issuer's right to repurchase.
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